Are you unable to work due to medical conditions? Does your employer offer short-term disability insurance (“STD”) as part of its group benefits plan? You may be asking: can I be fired if my short-term disability claim is denied?
In this article, we explain how short-term disability coverage works, why short-term disability claims are sometimes denied, and what your options are if your disability claim is denied. We want to ensure you know your options.
What is short-term disability?
Short-term disability is an income replacement benefit available through your employer’s group insurance policy. Short-term disability coverage is designed to support employees who are temporarily unable to work due to illness or injury.
STD benefits can range from 8 weeks to 6 months (and even beyond, depending on the specifics of your insurance coverage). If your condition continues beyond that period, long-term disability benefits may become available, but only after short-term disability benefits have ended and any required waiting period has been satisfied.
Who qualifies for short-term disability?
If you suffer from an illness or injury that prevents you from working, you may qualify for STD benefits. Conditions can be physical, psychological, or a combination of both. For example, if you’ve broken a bone outside of work, you will often qualify. Mental illness, such as anxiety or depression, may also qualify if it prevents you from performing your job duties.
To succeed, your short-term disability claim must be supported by medical evidence, often including medical records and an attending physician’s statement outlining your restrictions and limitations.
Why do people typically make short-term disability claims?
STD applications are typically made if a person is suffering from an illness or injury that stops them from completing the essential duties of their occupation. The illness or injury could be acute or is sometimes chronic in nature.
If your symptoms fall into any of the following examples, you may want to consider making an application for STD:
- Flare up of chronic back issues,
- Difficulty concentrating and/or sleeping,
- Issues with anxiety and depression,
- Broken or fractured bones,
- Cancer diagnosis,
- Issues with arthritis, and
- Fibromyalgia
The above isn’t an exhaustive list, but are common reasons why a person may consider applying for STD.
Common reasons short-term disability may get denied
Insurance companies are responsible for reviewing your disability claim and deciding whether it meets the definition of disability under the insurance policy. This includes reviewing medical records, your employee statement, your employer statement, and any attending physician’s statement on file.
A short-term disability denial could result for various reasons. Insurers may deny your claim, indicating that objective medical evidence doesn’t support a finding that you suffered an illness or injury as defined within the STD policy. Insurers are notorious for claiming insufficient medical evidence, cherry picking medical information, and misconstruing information you have provided them with to support a denial of your claim.
What happens if my short-term disability claim is denied?
If you have had your short-term disability denied, the insurer will notify you and your employer. This does not mean your medical leave is invalid. A denied short-term disability claim may be appealed, and additional medical evidence can often be provided to challenge the decision.
Can I be fired while on short-term disability in Canada?
Can you lose your job due to disability claims? The answer is no, but your employer may try.
If your STD claim is denied, the insurer will inform your employer of your denial. This will trigger your employer to reach out to you and ask when you will be returning to work. Your employer may even say your current medical leave is “unsubstantiated” or you’ve “abandoned” your position if you do not return by a certain date. Don’t be misguided by these empty threats. Approved and supported medical leaves are protected under the Ontario Human Rights Code (“OHRC”). Don’t be pressured to return to work if you aren’t medically fit.
Your employer isn’t allowed to fire you if you are on an approved medical leave as it is a violation of your rights. Your employer has a duty to respect your medical restrictions and reasonably accommodate you if and when you are ready to return to work.
Even if your short-term disability was denied, your employer must respect your medical restrictions and has a duty to accommodate you to the point of undue hardship. Terminating your employment in these circumstances may violate your rights.
If you’ve been terminated after taking a sick leave, speak with a disability lawyer immediately.
How can a short-term disability lawyer help you?
It is stressful if you’re unwell, dealing with an insurance company, your employer, and trying to keep up with medical appointments. It’s important to have a knowledgeable lawyer on your side to help you navigate any challenges that might come with disability insurance claims.
If you are considering a claim for STD, applied and been denied, or your employer is trying to force you back to work, you most likely need the help of an experienced disability lawyer.
The Toronto employment lawyers at Whitten & Lublin are here to help you take back control of your rights. We offer a free consultation for short and long-term disability claims. Contact us online or call 416-640-2667.
Author – Aman Chaggar
